"He who attends
on the sick attends on me," declared the Buddha, exhorting his
disciples on the importance of ministering to the sick. This famous
statement was made by the Blessed One when he discovered a monk lying
in his soiled robes, desperately ill with an acute attack of dysentery.
With the help of Ananda, the Buddha washed and cleaned the sick monk
in warm water. On this occasion he reminded the monks that they have
neither parents nor relatives to look after them, so they must look
after one another. If the teacher is ill, it is the bounden duty of
the pupil to look after him, and if the pupil is ill it is the teacher's
duty to look after the sick pupil. If a teacher or a pupil is not
available it is the responsibility of the community to look after
the sick (Vin.i,301ff.).

On another occasion
the Buddha discovered a monk whose body was covered with sores, his
robe sticking to the body with pus oozing from the sores. Unable to
look after him, his fellow monks had abandoned him. On discovering
this monk, the Buddha boiled water and washed the monk with his own
hands, then cleaned and dried his robes. When the monk felt comforted
the Buddha preached to him and he became an Arahant, soon after which
he passed away (DhpA.i,319). Thus the Buddha not only advocated the
importance of looking after the sick, he also set a noble example
by himself ministering to those who were so ill that they were even
considered repulsive by others.

The Buddha has
enumerated the qualities that should be present in a good nurse. He
should be competent to administer the medicine, he should know what
is agreeable to the patient and what is not. He should keep away what
is disagreeable and give only what is agreeable to the patient. He
should be benevolent and kind-hearted, he should perform his duties
out of a sense of service and not just for the sake of remuneration
(mettacitto gilanam upatthati no amisantaro). He should not feel repulsion
towards saliva, phlegm, urine, stools, sores, etc. He should be capable
of exhorting and stimulating the patient with noble ideas, with Dhamma
talk (A.iii,144).

Here it is noteworthy
that the nurse is expected to be efficient not only in taking care
of the body by giving proper food and medicine, but is also expected
to nurture the patient's mental condition. It is well known that the
kindness of nurses and doctors is almost as effective as medicine
for a patient's morale and recovery. When one is desperately ill and
feels helpless, a kind word or a gentle act becomes a source of comfort
and hope. That is why benevolence (metta) and compassion (karuna),
which are also sublime emotions (brahmavihara), are regarded
as praiseworthy qualities in a nurse. The sutta adds another dimension
to the nursing profession by including the spiritual element in a
nurse's talk. Sickness is a time when one is face to face with the
realities of life and it is a good opportunity to instill a sense
of spiritual urgency even in the most materialistic mind. Further,
the fear of death is naturally greater when a person is ill than when
well. The best means of calming this fear is by diverting attention
to the Dhamma. A nurse is expected to give this spiritual guidance
to the patient in his or her charge as a part and parcel of a nurse's
duty.

In the Anguttara
Nikaya the Buddha describes three types of patients (A.i,120). There
are patients who do not recover whether or not they get proper medical
attention and nursing care; there are others who recover irrespective
of whether or not they get medical attention and nursing care; there
are others who recover only with appropriate medical treatment and
care. Because there is this third type of patient, all those who are
ill should be given the best medical treatment available, agreeable
food and proper nursing care. So long as a patient is alive, everything
possible should be done for his recovery.

According to another
sutta (A.iii,56,62), illness is one of the inevitables in life. When
faced with it, all resources available to one, even magical incantations,
should be utilized with the hope of restoring health. Here the question
of whether such performances are effective or not is not discussed.
The point seems to be that at the time of a crisis there is no harm
in trying out even methods traditionally believed to be efficacious,
but in which one does not necessarily have faith or belief. Of course,
such methods should not clash with one's conscience. If, in spite
of these efforts, death does occur, then one has to accept it as a
verdict of kamma with equanimity and philosophical maturity.

Here we are reminded
of an episode (MA.i,203) where a mother who was critically ill needed
rabbit meat as a cure. The son, finding that rabbit meat was not available
in the open market, went in search of a rabbit. He caught one but
was loathe to kill even for the sake of his mother. He let the rabbit
go and wished his mother well. Simultaneously with this wish, the
power of the son's moral virtue brought about the mother's recovery.
The Buddhist tradition seems to hold that under certain circumstances
moral power has healing properties that may work even in cases when
orthodox medicine fails.

The Medicines
Chapter of the Vinaya Mahavagga (Vin.i,199ff.) shows that the
Buddha relaxed a number of minor disciplinary rules to accommodate
the needs of sick monks. Though a strict disciplinarian, the Buddha
has shown great sympathy and understanding to those who are ill. The
value of health has been fully realized and it is even recognized
as the greatest gain (arogyaparama labha, Dhp.204).

The Buddha teaches
that the patient too should cooperate with the doctor and the nurse
in order to get well. Such a good patient should take and do only
what is agreeable to him. Even in taking agreeable food he should
know the proper quantity. He should take the prescribed medicine without
fuss. He should honestly disclose his ailments to his duty-conscious
nurse. He should patiently bear physical pain even when it is acute
and excruciating (A.iii,144).

The suttas show
that the Buddha exercised great will power and composure on occasions
when he fell ill. He experienced excruciating pain when a stone splinter
pierced his foot after Devadatta hurled a boulder at him. He endured
such pain with mindfulness and self-composure and was not overpowered
by the pain (S.i,27, 210). During his last illness, too, the Buddha
mindfully bore up great physical pain and with admirable courage he
walked from Pava to Kusinara with his devoted attendant Ananda, resting
in a number of places to soothe his tired body (D.ii,128,134). The
Maha-Parinibbana Sutta also reports that the Buddha once willfully
suppressed a grave illness in Beluvagama and regained health (D.ii,99).

It seems that
those who are highly developed mentally are able to suppress illness,
at least on certain occasions. Once Nakulapita visited the Buddha
in old age, and the Master advised him to remain mentally healthy
even though the body is feeble (S.iii,1). There is physical and mental
pain (dve vedana kayika ca cetasika ca). If, when one has physical
pain, one becomes worried and adds mental pain too, that is like being
shot with two arrows (S.iv,208). One who is spiritually evolved is
capable of keeping the mind healthy proportionate to his spiritual
development. As an Arahant is fully developed spiritually, he is capable
of experiencing physical pain only, without mental pain (so ekam vedanam
vediyati kayikam na cetasikam, S.iv,209).

A number of suttas
advocate the recitation of the enlightenment factors (bojjhanga) for
the purpose of healing physical ailments. On two occasions, when the
Elders Mahakassapa and Mahamoggallana were ill, the Buddha recited
the enlightenment factors and it is reported that the monks regained
normal health (S.v,79-80). It is perhaps significant to note that
all the monks concerned were Arahants, and had therefore fully developed
the enlightenment factors. The Bojjhanga Samyutta also reports that
once when the Buddha was ill, he requested Cunda to recite the enlightenment
factors (S.v,81). The Buddha was pleased at the recitation and it
is said that he regained health. On another occasion, when the monk
Girimananda was very ill (A.v,109), the Buddha informed Ananda that
if a discourse on ten perceptions (dasa sañña) is delivered
to him, he might get well. The ten perceptions are the perception
of impermanence, egolessness, impurity of the body, evil consequences
(of bodily existence), elimination (of sense pleasures), detachment,
cessation, disenchantment with the entire world, impermanence of all
component things, and mindfulness of breathing. Ananda learnt the
discourse from the Buddha and repeated it for Girimananda and it is
reported that he recovered.

Once the Buddha
heard that a newly ordained monk who was not very well known among
his fellow monks was very ill (S.iv,46). The Buddha visited him. When
he saw the Buddha approaching him he stirred in his bed and tried
to get up, but the Buddha cautioned him not to rise. Having taken
a seat, the Buddha inquired after his health, whether the pains are
decreasing and not increasing. The monk replied that he is feeling
very ill and weak, that his pains are increasing and not decreasing.
The Buddha then inquired whether he had any misgiving or remorse.
The monk replied that he had plenty of misgiving and remorse. The
Buddha then asked whether he reproached himself for breach of virtue.
He said no. Then the Buddha asked why he felt remorseful if he was
not guilty of any breach of virtue. The monk replied that the Buddha
does not preach the doctrine for purity of virtue, but for detachment
from lust (ragaviragatthaya). Greatly pleased, the Buddha exclaimed
Sadhu Sadhu in approbation.

The Buddha then
went on to preach the doctrine to the monk. He explained that the
sense faculties are impermanent, unsatisfactory and egoless, therefore
they should not be considered as "I" and "mine."
Understanding their true nature the noble disciple becomes disenchanted
with the sense faculties. When this explanation of the Dhamma was
being given the vision of truth (dhammacakkhu) dawned on the
monk; he realized that whatever has the nature of arising necessarily
has the nature of cessation. In other words he became a sotapanna,
a stream-enterer.

According to the
Sotapattisamyutta Anathapindika was once very ill, and at his request
the Venerable Sariputta visited him (S.v,380). On being told that
the pains are excruciating and increasing Sariputta delivered a discourse
reminding Anathapindika of his own virtues. Sariputta explained that
the uninstructed worldling who has no faith in the Buddha, Dhamma
and Sangha and who has not cultivated virtuous moral habits goes to
a state of woe on the destruction of the body. But Anathapindika has
unshakable conviction in the Buddha, Dhamma and Sangha, and has cultivated
noble moral habits. Sariputta told him that when these noble qualities
are mindfully appreciated the pains would subside.

Further, Sariputta
pointed out that uninstructed worldlings reach a state of woe on the
disintegration of the body as they have not cultivated the Noble Eightfold
Path. But on the contrary Anathapindika has cultivated the Noble Eightfold
Path. When attention is paid to them and the noble qualities are appreciated
the pains would subside. It is reported that the pains subsided and
Anathapindika recovered from that illness. So much so, that Anathapindika
got out of bed and served the Venerable Sariputta with the meal that
was prepared for himself.

The Sotapattisamyutta
records an account of another occasion when Anathapindika was ill
(S.v,385). The Venerable Ananda was summoned to the bedside and he
delivered a discourse. Ananda explained that uninstructed ordinary
people who have no faith in the Buddha, Dhamma and Sangha and who
are given to immoral habits are seized with trepidation and fear at
the approach of death. But the noble disciple who has deep conviction
in the Buddha, Dhamma and Sangha and who has cultivated moral habits
does not experience trepidation and fear of death. Anathapindika then
confessed unshakable conviction in the Buddha, Dhamma and Sangha,
and declared that he is endowed with the spotless virtue of a householder.
Ananda exclaimed that it is indeed a great gain that Anathapindika
has disclosed the attainment of the fruit of stream-entry. It is,
however, not reported whether Anathapindika recovered straight away.

The Buddha recommends
that a monk should not relax his energy and determination for spiritual
progress even when he is ill (A.iv,335). It is possible that the illness
might deteriorate, and before that happens care should be taken to
advance spiritually as much as possible. After recovering from an
illness, too, one should not be negligent, because, should there be
a relapse, the chances of gaining higher spiritual attainments diminish.

The Buddhist method
of ministering to the sick, as is evident from the canonical texts
cited above, attaches great importance not only to proper medical
and nursing care, but also to directing the mind of the patient to
wholesome thoughts. There seems to be a belief that attention paid
to doctrinal topics, especially the recitation of virtues which one
has already cultivated, is endowed with healing properties. In the
case of the Buddha and Arahants the recitation of the bojjhangas has
restored normal health. In the case of the monk Girimananda, who was
probably not an Arahant at the time of his illness, it was a discourse
on the ten perceptions that restored his good health. Anathapindika
was a sotapanna and a discussion on the special qualities of a sotapanna
was instrumental for his speedy recovery. It may be that when one
is reminded of the spiritual qualities one has already acquired, great
joy arises in the mind. Such joy is perhaps capable even of altering
one's bodily chemistry in a positive and healthy manner.

Here we are reminded
of a relevant episode contained in the Papañcasudani (MA.i,78).
A monk while listening to the Dhamma was bitten by a snake. He ignored
the snake bite and continued to listen. The venom spread and the pain
became acute. He then reflected on the unblemished purity of his virtuous
conduct (sila) from the time of his higher ordination. Great
joy and satisfaction arose within him when he realized the spotless
nature of his character. This healthy psychological change acted as
anti-venom and he was immediately cured. These episodes seem to reveal
that when attention is drawn to one's own spiritual qualities at times
of serious illness, and pious joy wells up in the mind thereby, health-promoting
factors become activated in the body, perhaps by way of the secretion
of health-restoring hormones. That may be the mechanism by which spiritually
advanced individuals regain health when appropriate suttas are recited.

There is much
material in the Pali Canon on counseling the terminally ill. Speaking
about death to a terminally ill patient is not avoided as an unpleasant
topic. On the contrary, the reality of death and perhaps its imminence
are accepted without any pretense and the patient is made to face
the prospect of death with confidence and tranquillity.

The advice given
by Nakulamata to Nakulapita is extremely valuable in this connection
(A.iii,295-98). Once Nakulapita was seriously ill and his wife Nakulamata
noticed that he was anxious and worried. She advised him thus: "Please,
sir, do not face death with anxiety. Painful is death for one who
is anxious. The Buddha has looked down upon death with anxiety. It
may be you are anxious that I will not be able to support the family
after your death. Please do not think so. I am capable of spinning
and weaving, and I will be able to bring up the children even if you
are no more. Perhaps you are worried that I will remarry after your
death. Please do not think so. We both led pure wholesome lives according
to the noble conduct of householders. So do not entertain any anxiety
on that account. It may be you are worried that I will neglect attending
on the Buddha and the Sangha. Please do not think so. I will be more
devoted to the Buddha and the Sangha after your death. Perhaps you
are worried that I will neglect keeping to the precepts. Please do
not have any doubts on that account. I am one of those who fully practice
the moral habits declared for the laity, and if you wish please ask
the Buddha about this matter. Perhaps you fear that I have not gained
inner mental composure. Please do not think so. I am one of those
who have gained inner mental composure as much as a householder could
gain. If you have any doubts about this, the Buddha is at Bhesakalavana,
ask him. Perhaps it occurs to you that I have not attained proficiency
in the Buddha's dispensation, that I have not gone beyond doubt and
perplexity without depending on another. If you wish to have these
matters clarified ask the Buddha. But please do not face death with
anxiety, for it is painful and censured by the Buddha." It is
reported that after Nakulapita was thus admonished by Nakulamata,
he regained his health, and gone was that illness never to recur.
Later on this whole incident was narrated to the Buddha, who commended
Nakulamata for her sagacious advice.

The Sotapattisamyutta
contains a valuable discourse on the question of counseling the terminally
ill (S.v,408). Once Mahanama the Sakyan inquired from the Buddha how
a wise layman should advise another wise layman who is terminally
ill. Here it should be noted that both the counselor and the patient
are wise lay Buddhists. The Buddha delivered a whole discourse on
how this should be done. First, a wise layman should comfort a wise
layman who is terminally ill with the four assurances: "Be comforted
friend, you have unshakable confidence in the Buddha, Dhamma and Sangha,
that the Buddha is fully enlightened, the Dhamma is well proclaimed,
and the Sangha is well disciplined. You also have cultivated unblemished
virtuous conduct which is conducive to concentration." Having
thus comforted the patient with the four assurances, he should ask
him whether he has any longing for his parents. If he says yes, it
should be pointed out that death will certainly come whether he has
longing for his parents or not. Therefore it is better to give up
the longing. Then, if he says he gives up his longing for his parents,
he should be asked whether he has longing for his wife and children.
With the same reasoning he should be persuaded to give up that longing
too. Then he should be asked if he has any longing for the pleasures
of the senses. If he says yes, he should be convinced that divine
pleasures are superior to human pleasures, and should be encouraged
to aspire for divine pleasures. Then he should be gradually led up
the scale of divine pleasures and when he comes to the highest heaven
of the sense sphere, his attention should be diverted to the Brahma-world.
If he says he has resolved on the attainment of the Brahma-world,
he should be admonished that even the Brahma-world is characterized
by impermanence and the rebirth personality. Therefore it is better
to aspire for the cessation of the rebirth personality. If he can
establish his mind on the cessation of the rebirth personality, then,
the Buddha says, there is no difference between him and the monk who
is liberated.

This, no doubt,
is the highest form of counseling that can be given to a highly advanced
person who is terminally ill by an equally spiritually advanced person.
It is very clear from the discourse that the patient must be one who
is as advanced as a stream-enterer, as the four assurances or the
consoling factors mentioned at the very beginning of the discourse
are identical with the qualities of a stream-enterer.

The Cittasamyutta
contains an interesting episode of the death of a spiritually advanced
learned lay disciple (S.iv,302). Citta the householder was a non-returner
(anagamin, A.iii,451). When he fell critically ill, a group
of sylvan deities invited Citta to set his mind on becoming a universal
monarch (cakkavattiraja) because the aspirations of the virtuous
come to pass. He refused, saying that that too is impermanent. Though
lying on his deathbed he admonished his relatives, who had assembled
round him, on the importance of cultivating faith in the Buddha, Dhamma
and Sangha, and on the importance of charity, then he passed away.

According to the
Sotapattisamyutta the Buddha once visited the bedside of Dighavu the
lay disciple who was terminally ill (S.v,344). The Master advised
him to fix his attention on unwavering confidence in the noble qualities
of the Triple Gem and to will that he be endowed with spotless virtuous
conduct. Dighavu replied that these qualities of a stream-enterer
are already found in him. Then the Buddha advised him to be established
in those virtues and develop the six qualities conducive to understanding,
namely, the perception of the impermanence of all component things,
the unsatisfactoriness of all that is impermanent, the egolessness
of what is unsatisfactory, the perception of elimination, detachment
and cessation. Dighavu replied that these qualities too are found
in him, but he is concerned that his father will be sad when he dies.
Then Jotipala, his father, advised him not to be worried on that account,
but to pay heed to what the Buddha says. The Buddha, having admonished
him, left and Dighavu died soon after. Later the Buddha declared that
Dighavu passed away as a non-returner.

The brahmin Dhananjani
was an unscrupulous tax collector who exploited both the king and
the public (M.ii,184-96). The Venerable Sariputta met him once and
exhorted him on the evil consequences of an unrighteous life. Shortly
thereafter Dhananjani was seriously ill and Sariputta was summoned
to his bedside. On being inquired about his health, Dhananjani informed
Sariputta that he has an unbearable headache. Sariputta then engaged
him in a conversation gradually drawing his attention from lower to
higher realms of existence as far as the Brahma-world. Having thus
diverted the attention of the near-death patient to the Brahma-world,
Sariputta went on to explain the path leading to the attainment of
the Brahma-world, namely, the full development of the brahmaviharas
-- loving kindness, compassion, altruistic joy and equanimity -- to
suffuse all quarters. At the end of the discourse Dhananjani requested
Sariputta to convey his respects to the Buddha. Sariputta departed
and shortly afterwards Dhananjani died. It is reported that he was
reborn in the Brahma-world. Later when the matter was related to the
Buddha, he found fault with Sariputta for not having led Dhananjani
further on the spiritual path.

This sutta shows
that a man who had been unscrupulous in his dealings could also be
guided to a happier rebirth by counseling during the crucial period
just prior to death. It is highly doubtful whether any and every evil
doer could be thus guided towards rebirth in a happy realm. Perhaps
Dhananjani's good qualities outweighed his evil deeds (Dhp.173) and
that may be the reason why it was possible to lead him to rebirth
in a happy state by counsel offered by a noble Arahant at the hour
of death.

That this may
have been so can be inferred from the facts reported in the sutta
(M.ii,185). Sariputta made it a point to inquire about Dhananjani's
spiritual zeal, soon after inquiring about the Buddha's health, from
a monk coming from Rajagaha, when he himself was touring in the far
away Dakkhinapatha. It is very likely that Dhananjani was a faithful
patron of the Sangha when his first wife, a lady full of faith, was
alive. His second wife was a faithless woman. When Sariputta heard
that Dhananjani was negligent he was dismayed, and made up his mind
to talk to Dhananjani should the occasion arise to meet him.

Another important
noteworthy feature in this discourse is that the Venerable Sariputta
starts the discourse from the lowest state of existence, and works
upwards as far as the Brahma-world. Perhaps he started from the hells
because Dhananjani had deteriorated to that level. Sariputta may have
helped to remind him of his former good deeds, and also may have drawn
his attention to a relevant Dhamma discourse Sariputta had delivered
to him, perhaps only a few days prior to his illness. Thus by drawing
on the spiritual potential that was hidden in him, Sariputta may have
been able to help Dhananjani attain a happy rebirth by last minute
counseling.

Here we are reminded
of the episode of young Mattakundali (DhpA.i,26). When he was lying
on his death-bed the Blessed One appeared and Mattakundali, being
greatly pleased, generated much faith in the Buddha. Dying soon after,
he was reborn in a celestial realm.

A sutta in the
Sotapattisamyutta (S.v,386) maintains that when an uninstructed ordinary
person at the threshold of death sees that he has no faith in the
noble qualities of the Buddha, Dhamma and Sangha, and that he has
led an immoral life, great fear of death and trepidation arise in
him. But a person who has deep unwavering faith in the noble qualities
of the Triple Gem, and who is spotlessly pure in his conduct, experiences
no such fear of death and trepidation. It seems to be the guilty conscience
that causes much anguish at the moment of death. When there is fear
and anxiety at this crucial moment rebirth must take place in a sphere
that is proportionate and commensurate to that experience of anguish.

It is appropriate
to record here a relevant discussion Mahanama the Sakyan had with
the Buddha regarding the fate of one who meets with a violent death
(S.v,369). Mahanama tells the Buddha that when he comes to the serene
atmosphere of the monastery and associates with pious monks of noble
qualities, he feels quite calm and self-possessed. But when he goes
out into the streets of Kapilavatthu, busy with constant traffic,
he feels frightened over the future birth that would await him should
he meet with a violent death in a traffic accident. The Buddha assures
him that a person who has cultivated moral virtues and led a righteous
life need not entertain such fears. He explains the situation with
the help of a simile. If a pot of ghee is broken after being submerged
in water, the potsherds will sink to the riverbed, but the ghee will
rise to the surface. Similarly, the body will disintegrate, but the
cultured mind will rise up like the ghee.

It is the same
idea that is emphasized in suttas such as Sankharuppatti, (M.iii,99)
Kukkuravatika (M.i,387) and Tevijja (D.i,235). Rebirth usually depends
on the thoughts that are most often entertained during a life-time.
If one entertains thoughts and dispositions that are suitable for
an animal, for a dog or a cow as given in the Kukkuravatika Sutta,
then it is likely one will be reborn among these animals, i.e. among
beings who have similar dispositions. If, on the other hand, one has
entertained thoughts and dispositions comparable to those among the
Brahmas, by the cultivation of sublime emotions such as universal
love and compassion, one has a good chance of being reborn among the
Brahmas. Therefore preparation for death really has to be done while
living. Even to be guided in thought to a higher rebirth when death
is imminent one needs the prior requisite of faith in the ideal of
human virtue and understanding - for this is what is meant by having
faith in the Buddha, Dhamma and Sangha -- and the cultivation of moral
habits. If one lacks virtue, guidance of thought patterns at the hour
of death to a higher level will be difficult to the extent that one
is deficient in virtue. But however difficult and effective the actual
guidance may be, it is a Buddhist custom to invite a monk to the bedside
of a terminally ill patient with the hope that the chanting of certain
protective suttas (paritta) will help the patient to develop faith
and elevate his thoughts to a higher plane of spirituality.

We are reminded
here that, according to the Vinaya (iii,8), some previous Buddhas
such as Vessabhu, whose dispensations did not last long, used to instruct
their disciples by looking into their minds with telepathic powers
and guiding their thought patterns thus: "Think thus, do not
think thus, pay attention thus, do not pay attention thus, give this
up, develop this," etc. Perhaps this may be the technique used
by Gotama Buddha and his eminent disciples to guide thought patterns
of amenable adherents at the hour of death. They seem to have mainly
used more general techniques with lengthy doctrinal discourses at
other normal times in preference to guided meditation with insight
into the thought patterns of individuals.

The question may
arise of how effective spiritual guidance will be if the terminally
ill patient is unconscious. Here what is actually important is that
we are really unaware of the patient's mental condition at the hour
of death. The doctors and onlookers might conclude that the patient
is unconscious because he does not respond to his surroundings and
to the questions put to him. His five faculties may have become partly
or completely defunct, but nobody can be certain whether or not his
mental faculty is active. We certainly do not know what special potentialities
the mind harbors on the occasion of death. It is quite likely that
the mental faculty is most active at this crucial hour. Perhaps this
is the time that one has the most violent mental struggle, yearning
for life with the firm habitual resistance and protest against death.

It is our conjecture
that yearning for life is greatest when the fear of death is greatest.
The fear of death is greatest when one's sense of guilt is greatest,
the fear that one has squandered the great opportunity of human life,
an opportunity which could have been well utilized for spiritual growth.
If, on the other hand, one has well utilized the opportunity of human
life for spiritual growth, one can face the inevitability of death
with relative calm, contentment and happy satisfaction. One's rebirth
seems to be commensurate with one's spiritual potential, which in
Buddhist terminology is called kamma.

It is appropriate
to conclude this essay by giving thought to what we should do when
we visit a terminally ill patient. Our normal attitude is one of sadness
and pity, but Buddhism holds that it is wrong to entertain negative
thoughts at such a moment. It is my opinion that it would be helpful
to the terminally ill patient, and to any patient for that matter,
if we radiate thoughts of metta, loving kindness to him. As the dying
person's mind may be working at this crucial hour, unencumbered by
the limitations imposed by the physical sense faculties, it is possible
that the person's mind will be sensitive and receptive to the spiritual
thought waves of those around him. If negative thought waves are generated
by grief and lamentation the dying person may be adversely affected.
But if gentle thoughts of love and kindness are extended, such thoughts
may function as a subtle mental balm that allays the distress and
anxiety brought on by the approach of death and envelops the dying
person's mind in a warm protective cloak of consoling peace.

Abbreviations
All references in text are to the editions of the Pali Text Society,
Oxford.

Lily de Silva
is Professor of Pali and Buddhist Studies at the University of Peradeniya
in Sri Lanka. A regular contributor to Buddhist scholarly and popular
journals, she is also the editor of the Digha Nikaya Tika, published
by the Pali Text Society. Her previous BPS publications include One
Foot in the World (Wheel No. 337/338), The Self-Made Private Prison
(Bodhi Leaves No. 120), and Radical Therapy (Bodhi Leaves No. 123).

The Buddhist
Publication Society

The Buddhist Publication
Society is an approved charity dedicated to making known the Teaching
of the Buddha, which has a vital message for people of all creeds.

Founded in 1958,
the BPS has published a wide variety of books and booklets covering
a great range of topics. Its publications include accurate annotated
translations of the Buddha's discourses, standard reference works,
as well as original contemporary expositions of Buddhist thought and
practice. These works present Buddhism as it truly is - a dynamic
force which has influenced receptive minds for the past 2500 years
and is still as relevant today as it was when it first arose.

A full list of
our publications will be sent free of charge upon request.